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Shirai N, Choudhary S, Houle C. Gastric Neuroendocrine Tumors With Parietal Cell Atrophy in a Long-term Carcinogenicity Study in Rats. Toxicol Pathol 2022; 50:507-511. [PMID: 35510893 DOI: 10.1177/01926233221095445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Malignant neuroendocrine tumors were diagnosed in the stomach of two out of sixty female Sprague-Dawley rats treated for 89 weeks with a high dose of a novel, small molecule, cannabinoid-1 antagonist. The tumors were associated with parietal cell atrophy accompanied by foveolar hyperplasia of the glandular stomach mucosa. Parietal cell atrophy/foveolar hyperplasia was considered test article related at the high dose, given the higher incidence and severity relative to untreated controls, although the precise mechanism of the parietal cell atrophy was undetermined. Spontaneous gastric neuroendocrine tumors are very rare in rats, and the current cases were considered secondary to parietal cell atrophy causing reduced gastric acid secretion and subsequent overstimulation of gastrin release through a feedback loop.
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Affiliation(s)
- Norimitsu Shirai
- Drug Safety Research and Development, Pfizer Inc., Groton, Connecticut, USA
| | | | - Christopher Houle
- Drug Safety Research and Development, Pfizer Inc., Groton, Connecticut, USA
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Nyman RS, Cappelen-Smith J, Brismar J, von Sinner W, Kagevi I. Yield and Complications in Ultrasound-Guided Biopsy of Abdominal Lesions. Acta Radiol 2016. [DOI: 10.1177/028418519503600435] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A series of 458 consecutive ultrasound-guided biopsies in 347 patients − 171 fine-needle aspiration biopsies (FNABs) and 287 1.2-mm needle core biopsies (NCBs) − was analysed for diagnostic yield and complications. FNAB was diagnostic in 107 (64%) biopsies of focal lesions with a correct diagnosis of malignancy in 86 of 125 biopsies (69%) and of benign disease in 21 of 43 (49%) biopsies. NCB provided a correct diagnosis in 189 (90%) biopsies for focal lesions, divided into 140 of 159 (88%) correct for malignancy and 49 of 50 (98%) correct for benign disease. In 69 patients examined with both FNAB and NCB on the same occasion, 50 out of 55 malignant lesions were identified with NCB but only 34 with FNAB; all 14 benign lesions were correctly identified by NCB, and only 6 by FNAB. Clinical relevant bleeding complications occurred in 6 out of 458 biopsies (1.3%) − 3 out of 287 following NCB (1.0%) and 3 out of 171 following FNAB (1.8%). It is concluded that if FNAB is replaced with 1.2-mm NCB using an automated biopsy gun, the diagnostic accuracy for abdominal lesions increases significantly (p<0.001), while the complication rate remains the same.
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Affiliation(s)
| | | | | | | | - I. Kagevi
- Department of Internal Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
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3
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Elvin A, Wilander E, Öberg K, Eriksson B, Lindgren PG. Ultrasound-Guided Biopsies of Neuroendocrine Metastases. Acta Radiol 2016. [DOI: 10.1177/028418519303400509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Twenty-five patients with known neuroendocrine tumour disease were biopsied with 1.2 mm and 0.9 mm biopsy-gun needles to evaluate the respective diagnostic accuracy of the 2 needle sizes. The influence of treatment-related fibrosis on the histopathological diagnosis was also evaluated. The overall diagnostic accuracy with the 0.9 mm needle was 69% as compared to 92% with the 1.2 mm needle. This difference, however, seems more related to needle guiding difficulties with the 0.9 mm needle than to insufficient tissue yield. When the tumour was hit with both the 0.9 and the 1.2 mm needle the tissue yield was inferior with the 0.9 mm needle in only one of 16 cases. The increased amount of fibrous tissue due to interferon treatment did not seem to negatively influence the diagnostic accuracy.
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Shirai N, Papanikolaou A, Perry R. An Atypical Case of Islet Cell Hyperplasia in a Wistar Rat. Toxicol Pathol 2012; 40:819-22. [DOI: 10.1177/0192623312441410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present article describes an unusual proliferative islet finding observed incidentally in a young male Wistar rat in a 2-week toxicity study. Histologically, the islet lesion was characterized by diffuse enlargement of the islets, which consisted of peripheral proliferation of non-insulin-containing islet cells surrounding normal-appearing insulin-containing cells in the center. To the authors’ knowledge, this is the first report of spontaneous proliferative islet lesion composed of non-insulin-containing cells in young rats.
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Affiliation(s)
- Norimitsu Shirai
- Pfizer Global Research and Development, Groton, Connecticut, USA
| | | | - Rick Perry
- Pfizer Global Research and Development, Groton, Connecticut, USA
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5
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Neuroendocrine Tumors of the Pancreas and Gastrointestinal Tract and Carcinoid Disease. Surgery 2008. [DOI: 10.1007/978-0-387-68113-9_59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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6
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Malis DD, Demian NM, Lemos L, Wong ME. Carcinoid tumor presenting as trismus: immunohistochemical evidence of metastatic lung disease to the infratemporal fossa. J Oral Maxillofac Surg 2007; 65:1382-8. [PMID: 17577509 DOI: 10.1016/j.joms.2005.12.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2005] [Revised: 12/11/2005] [Accepted: 12/21/2005] [Indexed: 10/23/2022]
Affiliation(s)
- Didier D Malis
- Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
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8
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Abstract
Carcinoid tumors originate from the neuroendocrine cells throughout the body and are capable of producing various peptides. Their clinical course is often indolent but can also be aggressive and resistant to therapy. We examined all aspects of carcinoid tumors including the molecular biology oncogenesis, role of angiogenesis, recent advances in imaging, and therapy. The Medline and Cancerlit databases were searched using carcinoid as the keyword. English language manuscripts were reviewed and relevant references from a total of 7741 were found. All titles were screened and all the relevant manuscripts were analyzed; we found 307 references pertinent to the history, epidemiology, clinical behavior, pathology, pathophysiology, molecular biology, radiologic imaging, supportive care of carcinoid syndrome, and results of therapeutic clinical trials. Management of patients with carcinoid tumors requires an understanding of the disease process and a multimodality approach. Introduction of long-acting somatostatin analogues has resulted in significant advances in the palliative care of patients with carcinoid syndrome. However, advanced carcinoid tumor remains incurable. Existing therapies for advanced disease have low biologic activity, high toxicity, or both. Clearly, more research is necessary in the areas of molecular biology, targeted therapy, and development of new drugs Future advances in this field need to focus on clinical and biological predictors of outcome. Early works in the area of tumor biology such as the role of p53, bcl-2, bax, MEN1, FGF TGF PDGF and VEGF expression are of interest and need to be explored further.
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Affiliation(s)
- Isac I Schnirer
- Department of Gastrointestinal Oncology and Digestive Diseases, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77005-4341, USA
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Abstract
BACKGROUND Patterns of elevated serum peptides may reveal additional markers and permit better classification of tumors based on (secondary) peptide secretion. METHODS Fasting peptide profiles were obtained from 31 carcinoid patients. vasoactive intestinal peptide (VIP), pancreatic polypeptide (PP), neurotensin, substance P, gastrin-releasing polypeptide (GRP), calcitonin, gastrin, and pancreastatin were measured. Peptide elevation patterns were correlated with disease sites, syndrome, and survival. RESULTS Elevations in patients were as follows: VIP 0%, PP 13%, neurotensin 10%, substance P 20%, GRP 3%, calcitonin 10%, and gastrin 3%. There were no consistent patterns of elevated peptides with regard to site or syndrome. Pancreastatin was elevated in 81% of profiles and was the only abnormal peptide in 57% of patients. CONCLUSION Peptide profile results do not permit improved classification, predict syndrome development, or correlate with survival. In contrast, pancreastatin is elevated in most cases and may be utilized to monitor disease progression and evaluate response to therapy.
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Affiliation(s)
- Kristine Calhoun
- Division of Surgical Oncology, Oregon Health and Sciences University, 3181 SW Sam Jackson Park Road, L223A, Portland, OR 97201, USA
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Abstract
BACKGROUND Carcinoid tumours are a poorly defined collection of lesions, histopathologically indistinguishable from gastroentero-pancreatic neuroendocrine tumours. In this report, we discuss epidemiology and survival, clinical presentation, carcinoid valvular heart disease (CVHD), histopathological considerations and treatment options. METHODS Review and update of the literature. RESULTS The term carcinoid suggests a disease entity, but with increasing knowledge it becomes progressively confusing. To avoid further confusion, it is advisable to define these tumours using differentiation, stage, primary site, known tumour products and an associated clinical syndrome. Incidence varies between 0.8 and 1.9/100,000 population. About 20% present with metastases, with a 5-year survival varying between 15% and 35%. Metastatic disease frequently accompanies the carcinoid syndrome (flushing, diarrhoea, wheezing and CVHD). CVHD incidence is about 50%, and seems unrelated to disease duration and tumour mass. An aetiological relation of CVHD with urinary 5-HIAA remains to be confirmed. Resection is the only curative option. Surgery can also offer prolonged palliation and is needed to restore bowel transit in obstructive/ischaemic bowel problems. Adequate palliation of hormone-related symptoms can also be achieved by somatostatin analogues, meta-iodo-benzyl-guanidine preparations and interferon-alpha formulations, all with a 70% response rate. Embolization of liver metastases has led to objective responses in about 50% of patients, but is accompanied by significant side effects. CONCLUSIONS Most patients are cured by surgery. Symptom relief is the main target in metastatic disease and can be achieved by a range of equally potent biologically active medications, debulking surgery and hepatic embolization.
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Affiliation(s)
- P F H J Quaedvlieg
- Dept. of Gastroenterology, Netherlands Cancer Institute/Anthonie van Leeuwenhoek Ziekenhuis, Amsterdam
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11
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Cooper GJS. Amylin and Related Proteins: Physiology and Pathophysiology. Compr Physiol 2001. [DOI: 10.1002/cphy.cp070210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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12
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Tsuchiya A, Nozawa Y, Hasegawa A, Kishimoto M, Takenoshita S. A case of breast cancer with endocrine features. Breast Cancer 2001; 7:157-9. [PMID: 11029789 DOI: 10.1007/bf02967449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cancer with endocrine features rarely occurs in the breast. We report a case of breast cancer with endocrine features in an 80-year-old woman. The tumors were treated by wide excision and a postoperative histopathologic diagnosis of carcinoma of the breast with endocrine features was made. Immunostaining was positive for chromogranin A, neuron-specific enolase and synaptophysin, but weakly argyrophilic. Widespread metastases occurred two months postoperatively, and the patient died of breast cancer 6 months after the first treatment
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Affiliation(s)
- A Tsuchiya
- Department of Surgery II, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan
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13
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Dolan JP, Norton JA. Neuroendocrine Tumors of the Pancreas and Gastrointestinal Tract and Carcinoid Disease. Surgery 2001. [DOI: 10.1007/978-3-642-57282-1_41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Pawlak D, Malczyk E, Darewicz J, Azzadin A, Buczko W. Platelet serotonergic mechanisms in patients with cancer of the urinary bladder. Thromb Res 2000; 98:367-74. [PMID: 10828476 DOI: 10.1016/s0049-3848(00)00198-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Platelet reactivity of hypertensive patients and patients with cancer of the urinary bladder was examined in vitro in comparison with normotensive patients. A significant increase in free serotonin in the plasma of patients with cancer of the bladder and a less pronounced increase in hypertensive subjects was observed. The platelets in neoplastic disease and hypertension showed a significant reduction in the kinetics of serotonin uptake. However, the release reaction was markedly higher, compared with healthy volunteers. Enhancement of platelet aggregation with serotonin was much greater in patients with cancer of the bladder than in control groups and in hypertensive patients. These data indicate increased sensitivity to serotonin within the platelets of patients with cancer of the urinary bladder.
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Affiliation(s)
- D Pawlak
- Department of Pharmacodynamics, Medical Academy, Bialystok, Poland.
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Prinz C, Zanner R, Gerhard M, Mahr S, Neumayer N, Höhne-Zell B, Gratzl M. The mechanism of histamine secretion from gastric enterochromaffin-like cells. THE AMERICAN JOURNAL OF PHYSIOLOGY 1999; 277:C845-55. [PMID: 10564076 DOI: 10.1152/ajpcell.1999.277.5.c845] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Enterochromaffin-like (ECL) cells play a pivotal role in the peripheral regulation of gastric acid secretion as they respond to the functionally important gastrointestinal hormones gastrin and somatostatin and neural mediators such as pituitary adenylate cyclase-activating peptide and galanin. Gastrin is the key stimulus of histamine release from ECL cells in vivo and in vitro. Voltage-gated K(+) and Ca(2+) channels have been detected on isolated ECL cells. Exocytosis of histamine following gastrin stimulation and Ca(2+) entry across the plasma membrane is catalyzed by synaptobrevin and synaptosomal-associated protein of 25 kDa, both characterized as a soluble N-ethylmaleimide-sensitive factor attachment protein receptor protein. Histamine release occurs from different cellular pools: preexisting vacuolar histamine immediately released by Ca(2+) entry or newly synthesized histamine following induction of histidine decarboxylase (HDC) by gastrin stimulation. Histamine is synthesized by cytoplasmic HDC and accumulated in secretory vesicles by proton-histamine countertransport via the vesicular monoamine transporter subtype 2 (VMAT-2). The promoter region of HDC contains Ca(2+)-, cAMP-, and protein kinase C-responsive elements. The gene promoter for VMAT-2, however, lacks TATA boxes but contains regulatory elements for the hormones glucagon and somatostatin. Histamine secretion from ECL cells is thereby under a complex regulation of hormonal signals and can be targeted at several steps during the process of exocytosis.
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Affiliation(s)
- C Prinz
- Department of Medicine II, Technical University of Munich, D-81675 Munich, Germany.
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Zhang PJ, Harris KR, Alobeid B, Brooks JJ. Immunoexpression of villin in neuroendocrine tumors and its diagnostic implications. Arch Pathol Lab Med 1999; 123:812-6. [PMID: 10458829 DOI: 10.5858/1999-123-0812-iovint] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Villin, a 95-kd cytoskeletal protein associated with axial microfilament bundles of brush border microvilli, is mostly restricted to intestinal glandular tumors. Villin immunoexpression was recently observed in a small number of carcinoids of the intestinal tract and lung, but its significance in a broad category of neuroendocrine tumors has not been evaluated. DESIGN A total of 114 neuroendocrine tumors of different origins were tested for villin expression. They included gastrointestinal carcinoids (n = 30), lung carcinoids (n = 15), small cell carcinomas of the lung (n = 24), small cell carcinomas of other sites (n = 15), islet cell tumors (n = 8), Merkel cell carcinomas (n = 6), paragangliomas (n = 6), and others (n = 10). Nine round cell sarcomas were tested as well. RESULTS Villin immunoreactivity was present in 85% of gastrointestinal carcinoids and small cell carcinomas, but was found in only 40% of lung carcinoids. Other tumors tested were virtually negative for villin. In general, while cytoplasmic reactivity was most common, a characteristic apical membranous pattern simulating brush border was seen in 76% of the gastrointestinal carcinoids and in 50% of the lung carcinoids. CONCLUSIONS We found that villin was predominantly restricted to gastrointestinal neuroendocrine tumors (excluding islet cell tumors), although a small number of bronchial carcinoids may be positive as well. These results suggest a role for villin in the differential diagnosis of neuroendocrine tumors.
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Affiliation(s)
- P J Zhang
- Department of Pathology and Laboratory Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
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Ohrvall U. Intraoperative scintigraphic detection of abdominal endocrine tumors. Development and evaluation of hand held gamma sensitive probes for 111In. Ups J Med Sci 1998; 103:1-34. [PMID: 9789969 DOI: 10.3109/03009739809178942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- U Ohrvall
- Department of Surgery, Uppsala University Hospital
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Öhrvall U, Westlin JE, Nilsson S, Juhlin C, Rastad J, Lundqvist H, Åkerström G. Intraoperative gamma detection reveals abdominal endocrine tumors more efficiently than somatostatin receptor scintigraphy. Cancer 1997. [DOI: 10.1002/(sici)1097-0142(19971215)80:12+<2490::aid-cncr21>3.0.co;2-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Karlson BM, Forsman CA, Wilander E, Skogseid B, Lindgren PG, Jacobson G, Rastad J. Efficiency of percutaneous core biopsy in pancreatic tumor diagnosis. Surgery 1996; 120:75-9. [PMID: 8693427 DOI: 10.1016/s0039-6060(96)80244-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Radiologic diagnosis of pancreatic tumors exhibits limited precision. The aim of this study was to investigate the outcome and complications of pancreatic core biopsy in patients with suspected pancreatic neoplasms. METHODS One hundred patients underwent ultrasonography-guided core biopsy of 1.2 mm external diameter. Medical charts were examined for biochemical and clinical signs of complications. Final diagnosis was settled by operation, autopsy, and clinical signs of the disease including survival with at least 2.3 years of follow-up. RESULTS Histopathologic biopsy evaluation showed correct discrimination between exocrine and endocrine tumors and nonneoplastic conditions in 89 patients. No false-positive cancer diagnosis was found, and guidance on nature of primary tumors was obtained for eight of eight metastases. The sensitivity was 91% for exocrine and 87% for endocrine pancreatic tumors, and negative predictive values of these diagnoses were 83% and 97%, respectively. No clinically significant complications were noted. CONCLUSIONS Core biopsy is an attractive alternative to diagnostic laparotomy in unresectable pancreatic cancer and efficiently provides diagnosis of endocrine tumors and pancreatic metastases in conjunction with rare complications. Benign biopsy findings cannot be used to exclude presence of primary or metastatic pancreatic neoplasms.
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Affiliation(s)
- B M Karlson
- Department of Surgery, Uppsala University Hospital, Sweden
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van Maanen C, Klein WR, Dik KJ, van den Ingh TS. Three cases of carcinoid in the equine nasal cavity and maxillary sinuses: histologic and immunohistochemical features. Vet Pathol 1996; 33:92-5. [PMID: 8826014 DOI: 10.1177/030098589603300114] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Three cases of carcinoid tumor in horses are described. The tumors originated from the maxillary sinuses and the retrobulbar region and caused exophthalmos. Histologically, they had a characteristic endocrine pattern and were argyrophilic with the Grimelius stain. All tumors contained reactivity for neuron-specific enolase and synaptophysin. Two of three tumors were reactive for both bovine and porcine chromogranin A. These immunohistochemical results confirm the neuroendocrine nature of these tumors. Neuroendocrine cells could not be detected in the nasal mucosa and maxillary sinuses of a normal horse; therefore, the origin of these carcinoid tumors remains obscure.
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Affiliation(s)
- C van Maanen
- Department of Pathology, Utrecht University, Netherlands
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Hallberg A, Juhlin C, Berne C, Kämpe O, Karlsson FA. Islet cell antibodies: variable immunostaining of pancreatic islet cells and carcinoid tissue. J Intern Med 1995; 238:207-13. [PMID: 7673849 DOI: 10.1111/j.1365-2796.1995.tb00924.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Islet cell antibodies (ICA) in sera of patients with autoimmune diabetes mellitus generally stain not only the insulin-producing beta cells but also the non-beta cells of the islets of Langerhans. The antibodies have been reported to react also with the chromaffin cells of carcinoid tissue. In the present study, we examined in detail the reactivity of 10 ICA-positive sera of patients with new onset insulin-dependent diabetes mellitus (IDDM) and two sera of patients with stiff-man syndrome. DESIGN The sera were analysed by immunofluorescence and by immunoperoxidase staining of human islets as well as by immunoprecipitations using 35S-methionine labelled rat islet lysates. In addition, immunofluorescence analyses of carcinoid tissues were carried out. RESULTS Eight of the 10 IDDM-positive sera reacted with all islet endocrine cells, whereas two sera showed staining restricted to the beta cells, as did the two sera of the patients with stiff-man syndrome. All beta cell 'selective' sera, but only 6 of 8 'whole' islet positive sera, immunoprecipitated the 64.kDa glutamic acid decarboxylase (GAD) antigen. The staining of carcinoid tissue was variable and did not correlate with the 'whole' or 'selective' staining pattern of islets. CONCLUSION The data underline a heterogeneity of ICA and indicate the presence of a separate, non-GAD antigen in islet cells. It is possible that in future studies, a resolution of ICA titres with respect to different types of islet cellular reactivity might provide insights into the pathogenesis of IDDM and improve the prognostic implications of antibody determinations.
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Affiliation(s)
- A Hallberg
- Department of Internal Medicine, University Hospital, Uppsala University, Sweden
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Skogseid B, Grama D, Rastad J, Eriksson B, Lindgren PG, Ahlström H, Lörelius LE, Wilander E, Akerström G, Oberg K. Operative tumour yield obviates preoperative pancreatic tumour localization in multiple endocrine neoplasia type 1. J Intern Med 1995; 238:281-8. [PMID: 7673859 DOI: 10.1111/j.1365-2796.1995.tb00935.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The efficiency of pancreatic tumour localization was prospectively evaluated in 12 consecutive patients with multiple endocrine neoplasia type 1 (MEN1), who were subjected to extirpation of 56 islet cell neoplasms of 0.2-4 cm in diameter (mean 0.8 cm) during pancreatic resection and enucleation. Computed tomography, angiography of the coeliac trunc and superior mesenteric artery, and percutaneous ultrasound correctly localized 7-12% of the tumours and 21-37% of the 19 lesions measuring at least one centimetre in diameter. Transhepatic portal vein sampling correctly located tumour sites in the proximal or distal portions of the pancreas in four out of six patients, but demonstrated unsatisfactory specificity. Intra-operative ultrasound and bidigital palpation of the pancreas had overall sensitivities of 86 and 45%, respectively, and eight lesions below 0.3 cm in diameter remained undetected with intraoperative ultrasound. It is concluded that diagnosis of endocrine pancreatic neoplasms is biochemical in MEN1 and that broad screening of tumour markers efficiently reveals pancreatic involvement decades before the development of a clinically overt disease. Intra-operative ultrasound is a requisite for pancreatic endocrine surgery in MEN1, and it obviates the need for conventional pancreatic imaging unless a pre-operative search for metastatic disease and anatomical aberrations is considered important.
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Affiliation(s)
- B Skogseid
- Department of Internal Medicine, University Hospital, Uppsala, Sweden
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Juhlin C, Papanicolaou V, Arnberg H, Klareskog L, Lörelius LE, Rastad J, Oberg K, Akerström G. Clinical and biochemical effects in vivo of monoclonal antitumor antibody in Verner-Morrison's syndrome. Cancer 1994; 73:1346-52. [PMID: 8111700 DOI: 10.1002/1097-0142(19940301)73:5<1346::aid-cncr2820730507>3.0.co;2-c] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Monoclonal antibodies have not been evaluated in metastasizing endocrine tumors, even though these lesions may induce severe morbidity of hormone excess in absence of considerable tumor burden. METHODS A murine monoclonal antibody of the IgG2a subtype was generated by immunization with dispersed tumor cells from an endocrine pancreatic carcinoma associated with liver and peritoneal metastases as well as a therapy-resistant Verner-Morrison's syndrome. RESULTS Immunohistochemical staining disclosed selective tissue reactivity of the antibody and conspicuous immunostaining on the surface of the tumor cells. Infusion of 100 mg antibody over 2 days into the common hepatic artery of the patient was accompanied by reduced diarrhea volume until death 6 weeks later and transient elevation of total plasma immunoreactivity for vasoactive intestinal peptide due to large molecular forms of the peptide. Postmortem examination demonstrated disappearance of peritoneal metastases as well as absence of immunostaining for the injected antibody and the transferrin receptor within residual hepatic tumors. CONCLUSION The results substantiate that symptomatic alleviation and perhaps interference with tumor cell mass may be obtained with monoclonal antibodies in patients with endocrine tumors and that the antiidiotypic immunoglobulin response may play a role herein.
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Affiliation(s)
- C Juhlin
- Department of Surgery, Uppsala University Hospital, Sweden
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Elvin A, Oberg K, Lindgren PG, Lundkvist M, Wilander E, Ericsson A, Hemmingsson A. Interferon treatment of neuroendocrine tumour xenografts as monitored by MRI. Acta Oncol 1994; 33:567-71. [PMID: 7522488 DOI: 10.3109/02841869409083937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The neuroendocrine-differentiated colonic carcinoma cell line (LCC-18) was transplanted to 29 nude mice (Balb/c). The purpose of the present study was to establish an animal model that would allow monitoring with magnetic resonance imaging (MRI) of changes induced by interferon (IFN) therapy and to evaluate whether the therapeutic response, as expressed by changes in MR signal characteristics and tumour proliferation activity, could be modulated by different IFN dosages. IFN did not seem to have any obvious antiproliferative effect on the LCC-18 tumour cell line transplanted to nude mice and no convincing treatment-related changes in rho values or T1 and T2 relaxation values were observed. The animal model was probably unsuitable for demonstration of IFN effects.
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Affiliation(s)
- A Elvin
- Department of Diagnostic Radiology, University Hospital, Uppsala, Sweden
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25
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Prinz C, Kajimura M, Scott DR, Mercier F, Helander HF, Sachs G. Histamine secretion from rat enterochromaffinlike cells. Gastroenterology 1993; 105:449-61. [PMID: 7687574 DOI: 10.1016/0016-5085(93)90719-s] [Citation(s) in RCA: 228] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND In vivo studies have suggested an important role for gastric enterochromaffinlike (ECL) cells in mediating acid secretion. Direct evidence for this function is lacking and requires a preparation of highly purified ECL cells. This work investigates the possible role and mechanism of histamine release from the ECL cell in the peripheral regulation of acid secretion, using purified ECL cells from rat fundic mucosa. METHODS A combination of elutriation and density-gradient centrifugation was used to purify rat fundic ECL cells. Enrichment was determined by the presence of acidic vacuoles containing a V type adenosine triphosphatase, electron microscopy, immunostaining, and histamine content and release. RESULTS ECL cells were enriched at least 65-fold with respect to the fundic epithelium. Gastrin (EC50 0.2 nmol/L) and cholecystokinin octapeptide (nonsulfated, EC50 0.04 nmol/L) stimulated histamine release in a time- and dose-dependent manner, suggesting a CCK-B receptor subtype, confirmed by the inhibition of gastrin/CCK stimulation with the CCK-B antagonist L365,260. Somatostatin also inhibited gastrin-mediated histamine release. Single cell imaging showed that gastrin elevated intracellular cytosolic calcium concentration biphasically. Carbachol and the C kinase activator 120-tetradecanoylphorbol-13-acetate also stimulated histamine release. Epinephrine (blocked by propranolol), forskolin, and dibutyryl-5'-cyclic adenosine monophosphate were also effective, implicating a beta-adrenergic pathway. The H3 agonist R-alpha-methyl-histamine inhibited, whereas the H3-antagonist thioperamide potentiated gastrin/CCK stimulated histamine release. CONCLUSIONS These in vitro results support a central role for the ECL cell in the peripheral regulation of gastric acid secretion.
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Affiliation(s)
- C Prinz
- Department of Physiology and Medicine, University of California, Los Angeles
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Wilander E, Scheibenpflug L. Cytokeratin expression in small intestinal and appendiceal carcinoids. A basis for classification. Acta Oncol 1993; 32:131-4. [PMID: 7686762 DOI: 10.3109/02841869309083901] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
For a study of histogenesis of intestinal carcinoids a collection of 5 classical small intestinal carcinoids, 6 appendiceal carcinoids and 9 pheochromocytomas, were evaluated. The tumors were identified by routine morphology, silver staining and chromogranin immunocytochemistry and were then examined with regard to the expression of intermediate filaments of cytokeratin type. Eight different antisera identifying individual or combinations of cytokeratins were employed. All classical small intestinal carcinoids displayed cytokeratin immunoreactivity and an almost identical cytokeratin reaction was observed in the normal enterocytes of the small intestinal mucosa. Of the individual cytokeratin types, number 18 was most heavily expressed. The appendiceal carcinoids, like the pheochromocytomas, almost totally lacked a cytokeratin staining despite a positive reaction in the mucosa of the appendix. This, in agreement with some previous studies, indicates that the small intestinal carcinoids are histogenetically related to the epithelial cells of the intestinal mucosa, while the appendiceal carcinoids have a different histogenesis and are more like pheochromocytomas. The appendiceal carcinoid may represent a distinct type of intestinal paraganglioma. This offers one explanation for the different biological behavior of appendiceal carcinoids in comparison with the other intestinal carcinoids.
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Affiliation(s)
- E Wilander
- Department of Pathology, University Hospital, Uppsala, Sweden
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27
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Abstract
In this review, we evaluate radiological techniques currently used to localize gastroenteropancreatic (GEP) endocrine tumors. We also describe the visualization, using intravenous (IV) administration of two isotope-labeled somatostatin analogues (123I-Tyr3-octreotide and 111In-DTPA-octreotide) of islet-cell tumors in 25 patients and carcinoids in 39 patients. The primary tumor and previously unrecognized distant metastases were visualized in 20 of the 25 patients (80%) and in 37 of the 39 patients (95%). Parallel in vitro detection of somatostatin receptors on those tumors also visualized in vivo showed that ligand binding to the tumor in vivo represents binding to specific somatostatin receptors. The detection of somatostatin receptors on tumors in vivo predicted a good suppressive effect of octreotide on hormonal hypersecretion by these tumors. It is an easy, quick, and harmless procedure that is valuable in the localization of primary endocrine pancreatic tumors and their often radiologically and clinically unrecognized metastases. Future prospective controlled studies comparing this procedure with other radiological investigative techniques should demonstrate its sensitivity and specificity and determine the place of somatostatin receptor imaging in the localization of GEP endocrine tumors.
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Affiliation(s)
- S W Lamberts
- Department of Medicine, Erasmus University, Rotterdam, The Netherlands
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Park JG, Choe GY, Helman LJ, Gazdar AF, Yang HK, Kim JP, Park SH, Kim YI. Chromogranin-a expression in gastric and colon cancer tissues. Int J Cancer 1992; 51:189-94. [PMID: 1349007 DOI: 10.1002/ijc.2910510205] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
UNLABELLED We studied the expression of chromogranin A (CgA) in human gastric (n = 17) and colorectal (n = 18) adenocarcinomas by nucleic acid hybridization and immunohistochemical analyses using a specific monoclonal antibody (MAb) to human chromogranin A (CgA). Some corresponding adjacent non-malignant mucosal tissues were also examined. RESULTS (1) Northern blotting: of 3 normal gastric mucosas examined, 2 (67%) had an easily detected signal for expression of CgA. Only one of 14 gastric carcinomas (7%) and one of 18 colorectal carcinomas (6%) had easily detected RNA signals. (2) Immunohistochemical staining: all non-malignant samples of gastric and colonic mucosa contained CgA-positive neuroendocrine (NE) cells. Two of 17 (12%) gastric adenocarcinomas, and 3 of 18 (17%) of colorectal adenocarcinomas contained CgA-positive tumor cells. Interestingly, the positive cases detected by immunohistochemistry included both cases detected by Northern blotting. Of the 5 cases detected by immunohistochemistry, 2 gastric cancers and 1 rectal carcinoma contained many diffusely scattered positive cells, occurring singly or in small clusters, while 2 colorectal carcinomas contained only occasional single CgA-positive tumor cells. In one of the positive gastric cases, a well-differentiated adenocarcinoma arising in a tubular adenoma, both the adenomatous and the carcinomatous elements contained positively staining cells. Our specific assays for CgA indicate that (1) a NE cell component, either diffusely scattered or occasional, occurs in about 15% of gastric and colorectal tumors; (2) there is no correlation between the presence of NE cells and degree of tumor differentiation; and (3) because only a minority of the tumor cells in positive cases stain for CgA, immunohistochemistry is a more sensitive method than Northern blotting.
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Affiliation(s)
- J G Park
- Laboratory of Tumor Cell Biology, Seoul National University College of Medicine, Korea
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Abstract
The classical (mid-gut) carcinoids of the intestinal tract display a characteristic light microscopic morphology. However, sometimes intestinal tumours are seen resembling carcinoids and differential diagnostic difficulties arise. In the present study silver stains and immunoreactivities to chromogranin A + B, cytokeratins and epithelial membrane antigen (EMA) were evaluated as diagnostic adjuncts in six classical carcinoids and six intestinal carcinomas with carcinoid-like features. All classical carcinoids were argentaffin and argyrophil and contained a majority cell population with chromogranin immunoreactivity while only one carcinoid-like carcinoma was chromogranin-immunoreactive and the stained cells in that case represented a minority of the tumour cell population. The cytokeratins were shown to be non-discriminatory. However, EMA expression occurred in five intestinal carcinomas and in the majority of the tumour cells of four of these cases, while only one classical carcinoid displayed a few EMA positive cells. Thus, silver stains in combination with chromogranin A + B and EMA appears to be of value to discriminate between classical carcinoids and carcinoid-like intestinal carcinomas. Further when intestinal carcinoids and carcinoid-like carcinomas are diagnosed with the aid of various tumour markers both qualitative and quantitative considerations must be made.
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Affiliation(s)
- E Wilander
- Department of Pathology, University Hospital, Uppsala, Sweden
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Affiliation(s)
- J M Feldman
- Durham VA Medical Center, Department of Medicine, North Carolina
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